Princess Máxima Center opens international study ALLTogether1

The ALLTogether1 protocol concerns the treatment of children with acute lymphatic leukemia. The study is expected to last five years and will be carried out at (pediatric) oncology centers in as many as 14 European countries. Approximately 1,400 children per year will participate in the study, more than 110 of whom Dutch. Pediatric oncologists / researchers in a large part of Europe now follow the same treatment protocol. In this protocol, randomized studies are conducted to compare different treatments.

International cooperation

Until now, subsequent ALL protocols were simply given a number as their name. Since 2014 a new international consortium has collaborated in the field of ALL, and for this reason Rob Pieters, pediatric oncologist and member of the Princess Máxima Center’s Board of Directors, came up with a different name: All Together. The Netherlands has made an important contribution and coordinates various sub-studies from the Princess Máxima Center. Based on extensive analyses of the latest treatment results of all participating countries and on other studies worldwide, the ALLTogether1 protocol was developed step by step. Inge van der Sluis, principal investigator on behalf of the Máxima, says, ‘This requires a lot of time and openness from all experts in the field of leukemia in children.’

Noticeable

Inge van der Sluis: ‘What our children actually notice from this study? They receive the best treatment possible at the moment, based on the knowledge and experience from many countries. The treatment is becoming more and more tailor-made, adapted to the individual patient. For example, children are divided into different risk groups based on genetic abnormalities in leukemia cells and how well they respond to the start of therapy. Then, for children who have a very high chance of recovery, we look into whether we can make the therapy less intensive and hence reduce the side effects. For other children, we look into whether the chance of recovery will increase by adding new forms of immunotherapy and new chemotherapy agents to the two-year treatment. One patient will need more therapy, whereas another will be able to recover with less therapy.’

Research questions

In addition to the changes in therapy, many other studies are taking place in the background, for example to improve diagnostics, prevention and treatment of side effects, and more basic laboratory research into the underlying DNA abnormalities of leukemia cells. By joining forces, the important research questions will be answered more quickly. Everything for the ultimate goal: the best treatment for a higher survival rate with good quality of life for children with ALL.